Multiple diseases

Cardiovascular and cerebrovascular diseases encompass a group of common and serious conditions, primarily ischemic heart disease (including myocardial infarction), stroke, heart failure, peripheral artery disease, valvular heart disease, venous thromboembolism, aortic aneurysms, and aortic dissection…

Cardiovascular risk factors: a matter of prevention

Apart from heredity, gender, and age, these diseases all share a number of individual risk factors, most of which are modifiable:

• Smoking

• High blood pressure

• Diabetes

• High cholesterol

• Poor diet

• Overweight and obesity

• A sedentary lifestyle and physical inactivity

• Excessive alcohol consumption

• Sleep disorders

• Drug use

Other factors such as depression, chronic kidney disease, pregnancy-induced hypertension, hormone-dependent diseases, or environmental factors, such as air or noise pollution, have also been identified as risk factors for cardio-neuro-vascular diseases. The prevention and management of all these factors are major public health challenges.

The burden of cardiovascular and cerebrovascular diseases

Cardiovascular and cerebrovascular diseases are the leading cause of death worldwide. In France, although they were the leading cause of death for many years, they are now the second leading cause of death, after cancer, due to a steady decline in the number of cardiovascular deaths linked to improvements in prevention and therapeutic management.

A comprehensive surveillance system for cardio-neuro-vascular diseases

The Public Health France program on cardiovascular and cerebrovascular diseases aims to produce surveillance indicators for cardiovascular diseases and strokes (incidence, hospitalization rates, mortality, premature mortality, survival), and to describe their trends over time and across regions.

These indicators are also analyzed at the subnational level and broken down according to measures of social inequality.

To produce these indicators, the program relies on data from:

• The National Health Data System (SNDS), which includes:

  • Hospitalization data from the Information Systems Medicalization Program (PMSI) of the Technical Agency for Hospitalization Information (Atih)

  • Inter-insurance system healthcare utilization data (DCIR) from the National Health Insurance Fund (Cnam)

  • Data on medical causes of death from the Center for Epidemiology on Medical Causes of Death (CépiDc) of the National Institute of Health and Medical Research (Inserm)

• Registers of ischemic heart disease and stroke

• General population surveys with health examinations (ENNS, Esteban, Albane) or without (Drees disability-health surveys, Santé publique France Barometers).

• Specific surveys (Unono Wa Maore, SaMarOya)

This surveillance system relies on numerous partners:

• The National Health Insurance Fund (Cnam)

• The Technical Agency for Hospitalization Information (ATIH)

• The National Institute of Health and Medical Research (Inserm), particularly the Center for Epidemiology on Medical Causes of Death (CépiDc)

• Population-based registries of ischemic heart disease and stroke

• The Directorate for Research, Studies, Evaluation, and Statistics (Drees)

• The High Authority for Health (HAS), providing treatment guidelines for various cardiovascular conditions

• Professional societies (French Society of Cardiology, French Society of Hypertension, French Neurovascular Society, etc.)

• The French Cardiology Federation

• The French Observatory on Drugs and Drug Addiction (OFDT)

• The French National Agency for Medicines and Health Products Safety (ANSM)

• The Institute for Health Metrics and Evaluation (IHME)

Santé publique France also monitors the links between air pollution and health, including cardiovascular diseases.

Santé publique France is involved in the European joint initiative JACARDI, which aims to reduce the burden of cardiovascular diseases, diabetes, and associated risk factors, both at the individual and societal levels.

Prevention of cardiovascular risk factors

Santé publique France provides the general public with several websites outlining the lifestyle and dietary guidelines to follow to prevent vascular diseases. These sites promote a varied and balanced diet, regular physical activity, and reducing sedentary behavior, as well as offering advice on quitting smoking and reducing alcohol consumption.